Complete restored hearing loss after excessive nose blowing with various CT findings

A perilymphatic fistula (PLF) is defined as leakage of perilymph with several possible causes such as superior canal dehiscence through trauma, temporal bone fracture, or sudden pressure change (e.g., skydiving or scuba diving). Pneumolabyrinth can result from temporal bone fracture after trauma, or sudden pressure change in the middle ear or cerebrospinal fluid, such as excessive nose blowing or Valsalva maneuver. A PLF and pneumolabyrinth may occur without trauma, associated with a sudden pressure change in the middle ear. We report two cases of PLF followed by pneumolabyrinth and one case of suspicious PLF without pneumolabyrinth after excessive nose blowing. All three cases were diagnosed as having sensorineural hearing loss and the patients recovered completely after conservative treatment. We report various CT findings of pneumolabyrinth and PLF, from normal CT findings to air pockets in the labyrinth and soft tissue density around the stapes.